Abstract

Background: Resistin is a newly identified
adipocytokine, which has demostrated links between
obesity and insulin resistance in rodents. In humans,
pro-inflammatory properties of resistin are superior to
its insulin resistance-inducing effects. Objective: To
assess resistin expression in synovial tissues, serum
and synovial fluid from patients with rheumatoid
arthritis (RA), osteoarthritis (OA) and
spondylarthropaties (SpA), and to study its relationship
to inflammatory status and RA disease activity. Methods:
Resistin expression and localization in synovial tissue
was determined by immunohistochemistry and confocal
microscopy. Serum and synovial fluid resistin, leptin,
IL-1 beta;, IL-6, IL-8, TNF-alfa;, and MCP-1
levels were measured. The clinical activity of RA
patients was assessed according to the 28 joint count
Disease Activity Score (DAS28). Results: Resistin was
detected in both RA and OA synovium. Staining in the
sublining layer was more intensive in RA compared to OA
patients. In RA macrophages (CD68+), B-lymphocytes
(CD20+), and plasma cells (CD138+), but not T-
lymphocytes (CD3+) showed co-localization with resistin.
Synovial fluid resistin was higher in RA than in SpA or
OA patients (both p<0.001). In patients with RA and SpA,
serum resistin levels were higher compared to those in
patients with OA (p<0.01). Increased serum resistin in
RA patients correlated with both CRP (r=0.53, p<0.02),
DAS28 (r=0.44, p<0.05), but not with selected (adipo)
cytokines. Conclusion: The up-regulated resistin at
local sites of inflammation and the link between serum
resistin, inflammation, and disease activity suggest a
role for resistin in the pathogenesis of RA.

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